The Decision Tree

She was 140mg/dL when Mr. Rose dropped her off for her youth group at church a few years ago.

I immediately thought about what time her last bolus was, and knew in my gut she’d need two glucose tabs for a boost. I sat through the service feeling distracted. I kept checking my phone to make sure I hadn’t missed a call, and couldn’t stop replaying the scenario in my mind.

When I arrived to pick her up, she told me half-way through she felt low and tested — 83mg/dL. She treated herself with two glucose tabs, and was feeling totally fine.

Two glucose tabs.

I knew it.

For some reason, this seemingly normal, routine, incidental part of our life felt much bigger at that moment.

It felt downright HUGE.

At first I couldn’t put my finger on it. I mean, she had been testing her own blood sugar for a few years at that point. It was just another finger prick, right?

Every time a number flashes on the glucometer screen, there are a million variables that run through my brain. When was the last bolus? Has she had any recent physical activity? What type of carbs did she eat last? Have there been recent changes to her pump settings? …The list goes on and on and on… In my mind, there’s this decision tree…do this if you get that and these variables are present…do this if you get that and those variables are present. Come up with a different plan on the spot if none of the above apply.

She was EIGHT years old that day.

How did she know?

How did she know that two glucose tabs would do the trick? As opposed to three tabs…or a juice box…or both?

This is one of the most difficult aspects to managing type 1 diabetes.

The decision tree.

The flicker of thoughts that automatically start scrolling as you decide what action to take next. They’re like reflexes or breathing or something.

You can’t put it on paper. You can’t tell someone how to manage every possible scenario that could exist at any given moment.

Yet I’m her mom. I feel like it’s my job to take notes about her diabetes experiences. I should be authoring a life manual for her personal reference when she’s all grown up. It’s my job to TEACH her why two tabs were the answer on that particular day, given those particular set of variables.

I’ve read the books. I manage her numbers. I’m in control of her pump. I know which types of exercises cause the most drama. I talk to the doctors.

I learn from others in the Diabetes Online Community (DOC).

Even still, I don’t know.

I don’t know how I knew that two glucose tabs was the right thing to do that day.

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